iRhythm Technologies, Inc.

Second-quarter 2026 revenue was $224.2 million, up 20.1% year over year. Gross margin was 72.8%, up 160 basis points year over year. GAAP net loss was $0.4 million, or $0.01 per diluted share, versus a GAAP net loss of $14.2 million, or $0.44 per diluted share, in Q2 2025. Adjusted net income was $19.3 million, or $0.58 per diluted share, versus an adjusted net loss of $10.2 million, or $0.32 per diluted share, a year ago. Adjusted EBITDA was $43.3 million, or 19.3% of revenue, and free cash flow was $37.5 million. The company ended the quarter with $591.3 million in cash equivalents and marketable securities. For full-year 2026, iRhythm raised revenue guidance to $880 million-$890 million and adjusted EBITDA margin guidance to 13%-14%; Q3 revenue guidance is $221 million-$223 million and Q3 adjusted EBITDA margin guidance is 12%-13%. The VitalConnect deal is expected to contribute to revenue growth beginning in 2027; management said VitalConnect is currently at about a $65 million annual revenue run rate and expects the combined company to remain above 70% gross margin and achieve its previously communicated 15% adjusted EBITDA margin target in 2027. The transaction includes $50 million in equity, which Dan Wilson said equates to a little more than 420,000 shares, less than 1.5% dilution.

Quentin Blackford framed the quarter as evidence of durable demand for Zio, strong commercial execution, and growing operating leverage. He said VitalConnect meaningfully broadens the company’s platform into multiple MCT configurations and beyond ambulatory monitoring into hospital, hospital-to-home, and RPM use cases. His tone was upbeat but disciplined, repeatedly emphasizing integration execution, thoughtful investment, and a portfolio approach rather than relying on a single MCT product.

Dan Wilson highlighted strong operating leverage: revenue up 20.1% to $224.2 million, gross margin up to 72.8%, adjusted operating expenses essentially flat at $145 million, and adjusted EBITDA of $43.3 million, or 19.3% of revenue. He noted record free cash flow of $37.5 million and a quarter-end cash and marketable securities balance of $591.3 million, giving the company flexibility. On guidance, he raised full-year revenue to $880 million-$890 million and EBITDA margin to 13%-14%, while saying Q3 revenue should be $221 million-$223 million; he also said there was no tariff benefit in the quarter and that VitalConnect should help growth starting in 2027 while keeping combined gross margin above 70%.

Analysts focused heavily on the VitalConnect acquisition, asking whether it was mainly about MCT, whether it could cannibalize Zio MCT, and how the combined portfolio would be positioned against the existing AT and future MCT products. Management said the market needs multiple product offerings, that VitalConnect’s VitalPatch opens access to the remaining MCT segment plus adjacent opportunities like in-hospital monitoring, hospital-to-home, and RPM, and that Zio MCT remains a priority and is still being pursued with the FDA for first-half 2027 clearance. Other questions centered on margin upside, new store contribution, direct-to-patient efforts, and regulatory/HSR risks; management said margins will be balanced against growth investments, new-store contribution can fluctuate as prior accounts mature, direct-to-patient is still early but will likely be expanded, and the transaction is viewed as pro-competitive with confidence in FTC/HSR approval.